Jefferson Street Clinic, Sc

LBN: Jefferson Street Clinic, Sc
Jefferson Street Clinic, Sc is an health care organization with primary practice located at 107 E Jefferson Street , Morton IL 61550-0180. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Jefferson Street Clinic, Sc can be contacted via phone (309) 266-9711, or through Patton, Larry Stephen via phone (309) 266-9711.

Contact Information

Primary practice address
107 E Jefferson Street Morton IL 61550-0180
Phone: (309) 266-9711
Fax: (309) 266-6322
Website:
Map and Directions
Authorized official contact:
Name: Patton, Larry Stephen Doctor of Osteopathy (DO)
Phone: (309) 266-9711

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X Illinois

Profile Details

NPI number 1366637258
LBN Legal business name Jefferson Street Clinic, Sc
DBA Doing business as
Authorized official Patton, Larry Stephen Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 13th, 2007
Last updated Sep 13th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366637258 NPPES
Illinois Other 9015653 BLUE CROSS BLUE SHIELD

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